Case Management Associate

Sedgwick

1d•$17

About The Position

By joining Sedgwick, you'll be part of something truly meaningful. It’s what our 33,000 colleagues do every day for people around the world who are facing the unexpected. We invite you to grow your career with us, experience our caring culture, and enjoy work-life balance. Here, there’s no limit to what you can achieve. Newsweek Recognizes Sedgwick as America’s Greatest Workplaces National Top Companies Certified as a Great Place to Work® Fortune Best Workplaces in Financial Services & Insurance Case Management Associate PRIMARY PURPOSE: To access and assign workers compensation, disability and liability cases applying current policies and procedures per state workers compensation laws; and to increase efficiency of operation by providing general customer support duties and supporting the medical staff in a team environment. ARE YOU AN IDEAL CANDIDATE? We are looking for enthusiastic candidates who thrive in a collaborative environment, who are driven to deliver great work.

Requirements

Associate's degree or two (2) years of college preferred.
One (1) year of administrative experience required.
Knowledge of medical and insurance terms
Knowledge of ICD 9 and CPT coding systems
Excellent oral and written communication, including presentation skills
PC literate, including Microsoft Office products
Analytical and interpretive skills
Strong organizational skills; detail-oriented
Good interpersonal skills
Ability to work in a team environment
Ability to meet or exceed Performance Competencies

Nice To Haves

Customer service experience in a medical field preferred.
Worker's compensation, disability and/or liability claims processing experience preferred.

Responsibilities

Accesses and assigns cases for medical case management, utilization review and clinical consultation.
Provides accurate information to callers based on customer requests; triages telephone calls between utilization review, clinical consultation and telephonic case managers.
Enters new claims data into the claims management system accurately; maintains data integrity.
Supports clinical staff through the completion of components of the case management and utilization review process.
Schedules diagnostic tests and physician appointments as assigned.
Provides channeling services for injured workers, employers and claims examiners by directing into PPO network for treatment.
Gathers statistics for record keeping and provides reports as required.
Ensures by confirmation that fax forms and filings required by regulatory agencies have been received; distributes, faxes, mails and copies incoming and outgoing correspondence.
Performs other duties as assigned.
Supports other units as required.
Supports the organization's quality program(s).